TY - JOUR
T1 - Surgery to restore upper extremity function in tetraplegia—Preferences for early and frequent access to information
AU - L'Hotta, Allison J.
AU - James, Aimee S.
AU - Curtin, Catherine M.
AU - Kennedy, Carie
AU - Kenney, Deborah
AU - Tam, Katharine
AU - Ota, Doug
AU - Stenson, Katherine
AU - Novak, Christine B.
AU - Fox, Ida K.
N1 - Funding Information:
This work was supported by United States Department of Defense W81XWH‐17‐1‐0285 grant (entitled: Supporting Patient Decisions about Upper‐Extremity Surgery in Cervical SCI; PI: Ida Fox). The contents of this article do not represent the views of the U.S. Department of Veterans Affairs or the U.S. Government.
Funding Information:
Dr. Aimee James declares additional funding from the National Institutes of Health (NIH), National Cancer Institute, and is a Consultant on a NIH grant for the University of California San Diego. Dr. Catherine Curtin declares an unpaid role on the American Society for Peripheral Nerve (ASPN) Executive Council. Dr. Ida Fox declares fees paid for the 2021 American Association of Neuromuscular & Electrodiagnostic Medicine Meeting (AANEM) by AANEM and is an unpaid Historian for ASPN. Dr. Allison L'Hotta declares reimbursement from Dr. Fox's University funds for attendance at the 2021 American Spinal Injury Association Scientific Meeting. Dr. Christine Novak declares council membership of ASPN, Editorial Board member for the , and Associate Editor of . Dr. Doug Ota declares additional grants from the VA Office of Research and Development, VA Cooperative Studies Program #2003. Dr. Katherine Tam declares reimbursement by Veterans Health Administration for continuing professional education expenses (VHA directive 1049) and the Academy of Spinal Cord Injury Professionals Inclusion, Diversity, Equity and Accessibility Committee. Journal of Hand Surgery HAND
Publisher Copyright:
© 2022 American Academy of Physical Medicine and Rehabilitation.
PY - 2023/6
Y1 - 2023/6
N2 - Introduction: People with cervical spinal cord injury (SCI) identify improving upper extremity (UE) function as a top priority. In addition to comprehensive rehabilitation, UE surgeries, including nerve and tendon transfers, enhance function. However, barriers exist to disseminating information about surgical options to enhance UE function. Objective: To assess the experiences and preferences of people with cervical SCI and their caregivers in accessing information about surgery to enhance UE function. Design: Prospective cohort study. Participants were followed up for 24 months and completed up to three interviews. Setting: Tertiary care at academic and affiliated Veterans Administration Health Care Centers. Participants: Adults with cervical SCI (n = 35) ages 18 to 80 years with mid-cervical SCI American Spinal Injury Association Impairment Scale A, B, or C (at least 6 months post-injury) and their caregivers (n = 23) were eligible to participate. Participants were enrolled in three groups: nerve transfer, tendon transfer, or no UE reconstructive surgery. Interventions: Not applicable. Main Outcome Measure: Semi-structured interviews about surgical knowledge and experiences. Results: Data were analyzed and three themes were identified. First, providing information about UE surgical options early post-injury was recommended. The acute or inpatient rehabilitation phases of recovery were the preferred times to receive surgical information. Second, challenges with information dissemination were identified. Participants learned about UE surgery through independent research, medical provider interactions, or peers. Third, peers were identified as valuable resources for SCI needs and surgical information. Conclusions: Following cervical SCI, information about UE reconstructive surgeries should be a standard component of education during rehabilitation. An increased understanding of the reconstructive options available to improve UE function is necessary to educate stakeholders. Future research is needed to support the development of strategies to effectively present surgical information to individuals with SCI and health care providers.
AB - Introduction: People with cervical spinal cord injury (SCI) identify improving upper extremity (UE) function as a top priority. In addition to comprehensive rehabilitation, UE surgeries, including nerve and tendon transfers, enhance function. However, barriers exist to disseminating information about surgical options to enhance UE function. Objective: To assess the experiences and preferences of people with cervical SCI and their caregivers in accessing information about surgery to enhance UE function. Design: Prospective cohort study. Participants were followed up for 24 months and completed up to three interviews. Setting: Tertiary care at academic and affiliated Veterans Administration Health Care Centers. Participants: Adults with cervical SCI (n = 35) ages 18 to 80 years with mid-cervical SCI American Spinal Injury Association Impairment Scale A, B, or C (at least 6 months post-injury) and their caregivers (n = 23) were eligible to participate. Participants were enrolled in three groups: nerve transfer, tendon transfer, or no UE reconstructive surgery. Interventions: Not applicable. Main Outcome Measure: Semi-structured interviews about surgical knowledge and experiences. Results: Data were analyzed and three themes were identified. First, providing information about UE surgical options early post-injury was recommended. The acute or inpatient rehabilitation phases of recovery were the preferred times to receive surgical information. Second, challenges with information dissemination were identified. Participants learned about UE surgery through independent research, medical provider interactions, or peers. Third, peers were identified as valuable resources for SCI needs and surgical information. Conclusions: Following cervical SCI, information about UE reconstructive surgeries should be a standard component of education during rehabilitation. An increased understanding of the reconstructive options available to improve UE function is necessary to educate stakeholders. Future research is needed to support the development of strategies to effectively present surgical information to individuals with SCI and health care providers.
UR - http://www.scopus.com/inward/record.url?scp=85135461254&partnerID=8YFLogxK
U2 - 10.1002/pmrj.12862
DO - 10.1002/pmrj.12862
M3 - Article
C2 - 35665476
AN - SCOPUS:85135461254
SN - 1934-1482
VL - 15
SP - 731
EP - 741
JO - PM and R
JF - PM and R
IS - 6
ER -